Osteoarthritis patients do not need to stop working prematurely. Their work participation need not be affected if their lower work capacity is taken into consideration and workplaces are adapted. Movement scientist André Bieleman has revealed this in his thesis for which he will be awarded a PhD by the University of Groningen on 30 June 2010.
Osteoarthritis is a degenerative disease affecting the cartilage that also involves other joint structures. Osteoarthritis was long considered to be a normal and inevitable consequence of ageing, with few options for treatment. However, it has gradually become clear that many of those afflicted by it are under 65 and still employed. Their physical functioning and their work participation may be affected by the condition. Bieleman investigated the influence of the early stages of osteoarthritis on work participation. He carried out his research with a hip cohort and a knee cohort (CHECK – Cohort Heup En Cohort Knie) comprising 1002 participants aged between 45 and 65.
Hardly any difference
For his research, Bielefeld followed individuals with early osteoarthritis of the hip and/or knee for two years. His research has revealed no difference in work participation between that group and the general population in the Netherlands. The sick leave at both measurement points was not high; about 11 percent of the participants indicated that they had been on sick leave in the previous year. There was an increase in the percentage that indicated that they had made adjustments at work because of their complaints, from 14 percent at the beginning to 20 percent at the measurement after two years; a higher percentage indicated that they would like to make adjustments at work. Only a few people, however, had visited their company doctor to this end.
Functional capacity
Bieleman also investigated the participants’ functional capacity. They all indicated themselves that their physical functioning was poor. Their own judgment proved to be a good predictor of actual low functional capacity. The CHECK participants indeed have a lower functional capacity than their healthy working counterparts. A significant proportion of the women even have a functional capacity that can be deemed insufficient to be able to carry out work with low physical functioning requirements.
Occupational disability
In the first two years, early osteoarthritis of the hip and/or knee has a minor effect on work participation. According to Bieleman, the work adjustments which have put in place for CHECK participants or are desired by them, along with their low functional capacity, indicate that they are at risk of becoming unfit for work and having to quit working prematurely. He therefore recommends monitoring these factors. He also recommends that work should be discussed in every contact between the health professionals and the patient.
Curriculum Vitae
Andre Bieleman (Doetinchem, 1964) studied movement sciences at VU University Amsterdam. His research was funded in part by the Reumafonds (Dutch Arthritis Trust). Bieleman works at the Health, Wellbeing and Technology Knowledge Centre (Kenniscentrum Gezondheid, Welzijn en Technologie) of Saxion University of Applied Sciences in Enschede. Saxion will organize a symposium on his PhD results in Enschede on Wednesday 7 July. His thesis is entitled Work participation and work capacity in early osteoarthritis of the hip and knee. His supervisor is Prof. J.W. Groothoff.
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